J Gynecol Oncol.  2013 Apr;24(2):167-176. 10.3802/jgo.2013.24.2.167.

Survival of women with ovarian carcinomas and borderline tumors is not affected by estrogen and progesterone receptor status

Affiliations
  • 1Department of Obstetrics and Gynecology, Faculty of Medical Sciences, State University of Campinas-UNICAMP, Sao Paulo, Brazil. sophie.derchain@pq.cnpq.br
  • 2Department of Pathology, Faculty of Medical Sciences, State University of Campinas-UNICAMP, Sao Paulo, Brazil.
  • 3Department of Pathology, Laboratory of Investigative and Molecular Pathology, CIPED, State University of Campinas-UNICAMP, Campinas, Sao Paulo, Brazil.
  • 4Department of Pathology, Hospital do Cancer A C Camargo, Fundacao Antonio Prudente de Sao Paulo, Sao Paulo, Brazil.
  • 5Laboratory of Experimental Pathology, CAISM, State University of Campinas-UNICAMP, Sao Paulo, Brazil.
  • 6Faculty of Medical Sciences, State University of Campinas-UNICAMP, Sao Paulo, Brazil.

Abstract


OBJECTIVE
To examine the patterns of estrogen receptor (ER) and progesterone receptor (PR) expression in borderline ovarian tumors (BOTs) and ovarian carcinomas. We also assessed the disease-free survival (DFS) and overall survival (OS) in women with ovarian carcinoma, in relation to ER and/or PR expression.
METHODS
We examined ER/PR expression in 38 BOTs and 172 ovarian carcinomas removed from patients treated at the State University of Campinas-UNICAMP (Brazil), from 1993 to 2008 and followed for up to 60 months using tissue microarray-based immunohistochemistry.
RESULTS
Twenty-eight (73.7%) mucinous and 10 (26.3%) serous BOTs were included. Ovarian carcinomas consisted mainly of 79 (46.0%) serous, 44 (25.5%) mucinous, 17 (9.8%) endometrioid, 10 (5.8%) clear-cell types. There was no significant difference of the ER/PR expression between BOT and ovarian carcinoma (p=0.55 for ER alone, 0.90 for PR alone, and 0.12 for combined expression). The level of ER/PR expression in BOTs was significantly higher in serous than in mucinous tumors (p<0.01). In carcinomas, ER/PR was higher in serous tumors than in mucinous (p<0.01) and clear cell tumors (p=0.02), and higher in endometrioid tumors than in mucinous tumors (p<0.01). DFS was affected neither by the clinical characteristics nor by combined steroid receptor status. OS was found to be significantly worse (p<0.01) only in women with stages II-IV tumors and those with residual disease after surgery (p<0.01).
CONCLUSION
Overall, serous and endometrioid tumors were predominantly ER/PR positive, whereas mucinous and clear-cell tumors were preponderantly ER/PR negative. DFS and OS were not affected by ER/PR expression.

Keyword

Borderline ovarian tumor; Estrogen receptor; Immunohistochemistry; Ovarian carcinoma; Progesterone receptor; Tissue microarray

MeSH Terms

Disease-Free Survival
Estrogens
Female
Humans
Immunohistochemistry
Mucins
Progesterone
Receptors, Progesterone
Receptors, Steroid
Estrogens
Mucins
Progesterone
Receptors, Progesterone
Receptors, Steroid

Figure

  • Fig. 1 Representative immunohistochemical nuclear staining of progesterone receptor (PR) and estrogen receptor (ER). (Peroxidase). (A) PR: zero score (negative). (B) PR: 1%-10% cells stained/moderate intensity (final scoring 2+2=4). (C) PR: 35%-75% cells stained/strong intensity (final scoring 4+3=7). (D) PR: ≥75% cells stained/strong intensity (final scoring 5+3=8). (E) ER: zero score (negative). (F) ER: 1%-10% cells stained/moderate intensity (final scoring 2+2=4). (G) ER: 35%-75% cells stained/strong intensity (final scoring 4+3=7). (H) ER: ≥75% cells stained/strong intensity (final scoring 5+3=8). Peroxidase (A, B) ×40, (C, D) ×100, (E, H) ×400.

  • Fig. 2 Kaplan-Meier depiction of overall survival probabilities of women with (A) serous/endometrioid International Federation of Gynecology and Obstetrics (FIGO) stage I; (B) mucinous/clear cells/other FIGO stage I; (C) serous/endometrioid stages II-IV; and (D) mucinous/clear cells/other FIGO stages II-IV epithelial ovarian cancer. ER, estrogen receptor; PR, progesterone receptor status.


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